利用者:Anesth Earth/sandbox
ウィキペディア フリーな encyclopedia
Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance. Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids.[5] Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower than 7.35.[6] Acidemia and acidosis are not mutually exclusive – pH and hydrogen ion concentrations also depend on the coexistence of other acid-base disorders; therefore, pH levels in people with metabolic acidosis can range from low to high.
代謝性アシドーシス | |
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The calculated level of bicarbonate in the blood (HCO3−) reflects the severity of acidosis. | |
概要 | |
種類 |
Acute Metabolic Acidosis |
診療科 | Nephrology |
原因 |
Acute: Excessive amounts of organic acids; |
診断法 | Level of bicarbonate (HCO3-) in the blood |
合併症 |
Acute: poor morbidity and mortality outcomes; |
治療 |
Acute: Mitigation of the underlying cause for the metabolic problem, such as administration of insulin in cases of diabetic ketoacidosis or restoration of effective circulating intravascular volume in cases of lactic acidosis. The administration of IV bicarbonate, although intellectually appealing, is rarely indicated or administered Chronic: Diet rich in fruits and vegetables, oral alkali therapy[1] |
頻度 |
Acute: Most often presented during critical illnesses, and hospitalizations: incidence ranging from 14-42%.[2][3] |
分類および外部参照情報 | |
代謝性アシドーシスは、体内の酸塩基平衡の不均衡を特徴とする電解質異常である。代謝性アシドーシスには、酸産生の増加、重炭酸塩の喪失、および過剰な酸を排泄する腎臓の機能低下という3つの主な根本原因がある[5]。代謝性アシドーシスは、動脈血pHが7.35より低くなると定義されるアシデミアにつながる可能性がある[6]。アシデミアとアシドーシスは相互に排他的なものではなく、pHおよび水素イオン濃度は、他の酸塩基障害の併存にも依存する。
Acute metabolic acidosis, lasting from minutes to several days, often occurs during serious illnesses or hospitalizations, and is generally caused when the body produces an excess amount of organic acids (ketoacids in ketoacidosis, or lactic acid in lactic acidosis). A state of chronic metabolic acidosis, lasting several weeks to years, can be the result of impaired kidney function (chronic kidney disease) and/or bicarbonate wasting. The adverse effects of acute versus chronic metabolic acidosis also differ, with acute metabolic acidosis impacting the cardiovascular system in hospital settings, and chronic metabolic acidosis affecting muscles, bones, kidney and cardiovascular health.[7]
急性代謝性アシドーシスは、数分から数日間続くもので、重篤な病気に起こることが多く、一般に、体内で有機酸(ケトアシドーシスではケト酸、乳酸アシドーシスでは乳酸)が過剰に産生されたときに起こる。慢性代謝性アシドーシスは、週から年の単位で起こるもので、腎機能障害(慢性腎臓病)および/または重炭酸塩の消耗の結果として起こりうる。急性代謝性アシドーシスと慢性代謝性アシドーシスの悪影響もまた異なり、急性代謝性アシドーシスは病院環境において心臓血管系に影響を及ぼし、慢性代謝性アシドーシスは筋肉、骨、腎臓および心臓血管の健康に影響を及ぼす[7]。